The relationship between soluble CD73 and the incidence of septic shock in severe sepsis patients: a cross-sectional analysis of data from a prospective FINNAKI study.

Background: Sepsis is a leading cause of mortality worldwide. Septic shock is a subtype of sepsis in which the underlying cardiovascular and cellular/metabolic disorders are profound enough to increase mortality significantly. We sought to investigate the association between soluble cluster of differentiation-73 (sCD73) and the incidence of septic shock in severe sepsis patients. Methods: This cross-sectional study included 588 Finnish patients with severe sepsis or septic shock from the Finnish Acute Kidney Injury (FINNAKI) study. The primary exposure of interest was baseline level of sCD73. The outcome was the incidence of septic shock. Multivariable logistic regression analyses were performed to assess the independent association between sCD73 and the incidence of septic shock. Results: The average age of 588 participants was 62±16 years, and 65.14% of the patients were male. The average sCD73 was 5.11 (interquartile range, 3.30, 8.25) ng/mL. The incidence of sepsis shock was 429 (72.96%). In the multivariate logistic regression model, sCD73 was negatively associated with septic shock. After multiple adjustments (for age, gender, lactate, the Sequential Organ Failure Assessment score, systolic heart failure, emergency admission, operative admission, and acute kidney injury within 12 h), a 1 ng/mL increment in sCD73 was associated with a 5% lower incidence of septic shock [odds ratio (OR) =0.95; 95% confidence interval (CI): 0.92, 0.98; P<0.001]. Conclusions: We found that sCD73 was negatively correlated with septic shock. Higher sCD73 was associated with a lower incidence of septic shock. Keywords: Septic shock; severe sepsis; soluble cluster of differentiation-73 (sCD73); inflammation; phosphatidylinositol 3-kinase/Akt signaling (PI3K/Akt signaling).